Original Article
Impact of National Guidelines on Brachytherapy Monotherapy Practice Patterns for Prostate Cancer Yolanda D. Tseng, MD1; Alan T. Paciorek, BS2; Neil E. Martin, MD, MPH3; Anthony V. D’Amico, MD, PhD3; Matthew R. Cooperberg, MD, MPH2; and Paul L. Nguyen, MD3
BACKGROUND: In 1999 and 2000, 2 national guidelines recommended brachytherapy monotherapy (BT) primarily for treatment of low-risk prostate cancer but not high-risk prostate cancer. This study examined rates of BT use before and after publication of these guidelines, as compared with 4 other treatment options. METHODS: From 1990 to 2011, 8128 men with localized prostate cancer ( T3cN0M0) were treated definitively within the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry with 1 of 5 primary treatments: BT, external beam radiotherapy (EBRT), EBRT with androgen deprivation therapy, EBRT1BT, or radical prostatectomy. Men were categorized into low-, intermediate-, and high-risk groups based on the guidelines’ risk-group definitions. Within each risk group, logistic regression was used to estimate odds ratios (OR) comparing BT with other treatment options between the 1990-1998 and 1999-2011 periods, adjusting for age, disease characteristics, and clinic type. RESULTS: In total, 1117 men received BT alone for low- (n 5 658), intermediate- (n 5 244), or high-risk disease (n 5 215). BT comprised 6.1% of all treatments in 1990-1998 versus 16.6% in 1999-2011 (P
Impact of National Guidelines on Brachytherapy Monotherapy Practice Patterns for Prostate Cancer Yolanda D. Tseng, MD1; Alan T. Paciorek, BS2; Neil E. Martin, MD, MPH3; Anthony V. D’Amico, MD, PhD3; Matthew R. Cooperberg, MD, MPH2; and Paul L. Nguyen, MD3
BACKGROUND: In 1999 and 2000, 2 national guidelines recommended brachytherapy monotherapy (BT) primarily for treatment of low-risk prostate cancer but not high-risk prostate cancer. This study examined rates of BT use before and after publication of these guidelines, as compared with 4 other treatment options. METHODS: From 1990 to 2011, 8128 men with localized prostate cancer ( T3cN0M0) were treated definitively within the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry with 1 of 5 primary treatments: BT, external beam radiotherapy (EBRT), EBRT with androgen deprivation therapy, EBRT1BT, or radical prostatectomy. Men were categorized into low-, intermediate-, and high-risk groups based on the guidelines’ risk-group definitions. Within each risk group, logistic regression was used to estimate odds ratios (OR) comparing BT with other treatment options between the 1990-1998 and 1999-2011 periods, adjusting for age, disease characteristics, and clinic type. RESULTS: In total, 1117 men received BT alone for low- (n 5 658), intermediate- (n 5 244), or high-risk disease (n 5 215). BT comprised 6.1% of all treatments in 1990-1998 versus 16.6% in 1999-2011 (P
